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Extent of Inclusion of “Rural” in Comprehensive Cancer Control Plans in the United States

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Figure 1. Number of elements included in cancer control plans and whether plan included a rural-specific strategy, by state. Plans were assessed as to their inclusion of “rural” across 7 elements: 1) data on cancer burden, 2) reduction of cancer disparities, 3) rural population description, 4) rural definition, 5) goals, 6) objectives, and 7) strategies. Data source: National Comprehensive Cancer Control Program, Centers for Disease Control and Prevention.

Number of elements included in cancer control plans and whether plan included a rural-specific strategy, by state. Plans were assessed as to their inclusion of “rural” across 7 elements: 1) data on cancer burden, 2) reduction of cancer disparities, 3) rural population description, 4) rural definition, 5) goals, 6) objectives, and 7) strategies. Data source: National Comprehensive Cancer Control Program, Centers for Disease Control and Prevention.
State No. of elements Rural-specific strategy
Alabama 2 No
Alaska 2 Yes
Arizona 0 No
Arkansas 4 Yes
California 2 No
Colorado 1 Yes
Connecticut 1 No
Delaware 0 No
Florida 2 No
Georgia 2 No
Hawaii 0 No
Idaho 3 Yes
Illinois 2 No
Indiana 2 Yes
Iowa 2 No
Kansas 3 Yes
Kentucky 1 Yes
Louisiana 3 No
Maine 0 No
Maryland 3 Yes
Massachusetts 0 No
Michigan 0 No
Minnesota 1 No
Mississippi 3 Yes
Missouri 2 Yes
Montana 2 Yes
Nebraska 1 No
Nevada 3 No
New Hampshire 0 No
New Jersey 2 Yes
New Mexico 4 No
New York 3 Yes
North Carolina 2 No
North Dakota 1 Yes
Ohio 0 No
Oklahoma 2 Yes
Oregon 5 Yes
Pennsylvania 2 Yes
Rhode Island 0 No
South Carolina 0 No
South Dakota 1 No
Tennessee 2 Yes
Texas 2 No
Utah 2 No
Vermont 0 No
Virginia 2 No
Washington 1 No
West Virginia 3 No
Wisconsin 0 No
Wyoming 3 No

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Figure 2. Percentage of state population residing in rural counties, rural cancer mortality rate, and inclusion of rural elements in comprehensive cancer control plan (CCCP), by state. A, Percentage of state population living in rural counties, in tertiles, and number of rural elements in state CCCP. B, Percentage of state population living in rural counties, in tertiles, and whether rural-specific strategy included in state CCCP. C, Age-adjusted cancer mortality rate per 100,000 in rural counties, in tertiles (2013–2017), and number of elements addressed in state CCCP. D, Age-adjusted cancer mortality rate per 100,000 in rural counties, in tertiles (2013–2017), and whether rural-specific strategy included in state CCCP.

Percentage of state population residing in rural counties, rural cancer mortality rate, and inclusion of rural elements in comprehensive cancer control plan (CCCP), by state. A, Percentage of state population living in rural counties, in tertiles, and number of rural elements in state CCCP. B, Percentage of state population living in rural counties, in tertiles, and whether rural-specific strategy included in state CCCP. C, Age-adjusted cancer mortality rate per 100,000 in rural counties, in tertiles (2013–2017), and number of elements addressed in state CCCP. D, Age-adjusted cancer mortality rate per 100,000 in rural counties, in tertiles (2013–2017), and whether rural-specific strategy included in state CCCP.
State No. of Elements Rural-Specific Strategy % of Population That Lives in Rural Counties Tertile of % Rural (Low, Middle, High)a Age-Adjusted Cancer Mortality Rate per 100,000 in Rural Counties Tertile of Cancer Mortality Rate (Low, Middle, High)b
Alabama 2 No 23.7 Middle 182.9 High
Alaska 2 Yes 32.4 High 165.6 Middle
Arizona 0 No 5.1 Low 134.0 Low
Arkansas 4 Yes 38.3 High 191.2 High
California 2 No 2.2 Low 157.0 Low
Colorado 1 Yes 12.7 Middle 131.6 Low
Connecticut 1 No 5.1 Low 143.3 Low
Delaware 0 No 0 Low
Florida 2 No 3.5 Low 190.3 High
Georgia 2 No 17.4 Middle 179.6 High
Hawaii 0 No 18.8 Middle 141.2 Low
Idaho 3 Yes 33.4 High 154.3 Low
Illinois 2 No 11.5 Low 179.1 Middle
Indiana 2 Yes 22.2 Middle 180.7 High
Iowa 2 No 41.0 High 165.6 Middle
Kansas 3 Yes 32.3 Middle 170.6 Middle
Kentucky 1 Yes 41.4 High 211.2 High
Louisiana 3 No 16.4 Middle 195.6 High
Maine 0 No 41.0 High 177.5 Middle
Maryland 3 Yes 2.5 Low 155.8 Low
Massachusetts 0 No 1.5 Low 153.7 Low
Michigan 0 No 18.1 Middle 172.9 Middle
Minnesota 1 No 22.5 Middle 157.7 Low
Mississippi 3 Yes 54.1 High 193.8 High
Missouri 2 Yes 25.5 Middle 185.6 High
Montana 2 Yes 64.7 High 153.1 Low
Nebraska 1 No 35.3 High 155.3 Low
Nevada 3 No 9.4 Low 163.7 Middle
New Hampshire 0 No 37.2 High 161.3 Middle
New Jersey 2 Yes 0 Low
New Mexico 4 No 33.1 High 149.1 Low
New York 3 Yes 7.1 Low 165.8 Middle
North Carolina 2 No 21.9 Middle 172.5 Middle
North Dakota 1 Yes 50.4 High 150.4 Low
Ohio 0 No 20.4 Middle 181.2 High
Oklahoma 2 Yes 34.5 High 189.3 High
Oregon 5 Yes 16.3 Middle 175.3 Middle
Pennsylvania 2 Yes 11.6 Low 171.7 Middle
Rhode Island 0 No 0.0 Low
South Carolina 0 No 15.3 Middle 184.1 High
South Dakota 1 No 52.2 High 158.8 Low
Tennessee 2 Yes 22.7 Middle 195.3 High
Texas 2 No 11.1 Low 165.9 Middle
Utah 2 No 10.6 Low 132.1 Low
Vermont 0 No 65.3 High 166.6 Middle
Virginia 2 No 12.6 Low 184.4 High
Washington 1 No 10.1 Low 161.2 Middle
West Virginia 3 No 38.4 High 189.8 High
Wisconsin 0 No 26.0 Middle 166.1 Middle
Wyoming 3 No 69.4 High 138.3 Low

a Low, 0%–12.6%; middle, 12.7%–32.3%; high, 32.4%–69.5%.
b Per 100,000 population: low, 131.6–158.8; middle, 158.9–179.1; high, 179.2–211.2.

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